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AMPS · 4 days ago

Clinical Pharmacist

Arizona

Full-time

Onsite

Senior Level

5+ years exp

AMPS is a company that provides market-leading healthcare cost containment services. They are seeking a Clinical Pharmacist who will act as the primary liaison for clinical and cost containment insights, ensuring client satisfaction and retention while handling various pharmacy-related tasks and reporting.

Insurance

Responsibilities

Maintain confidentiality and HIPAA guidelines to ensure the confidentiality of all members and clients

Provide overview and advice on local, state, and federal legislative, legal, and industry requirements for PBM practices, including but not limited to PPACA, HIPAA, etc

Review, edit, maintain, or create and support standard and client-specific drug formularies and formulary management efforts for PBM and RBR/MBR customers and prospects

Review, edit, maintain, or create and support standard and client-specific Prior Authorization protocols

Review and determine clinical dispositions regarding pharmacy, patient, and prescriber-generated prior authorization requests per established response guidelines determined by the company and its client contracts requirements

Review, edit, maintain, or create and support standard and client-specific MAC (Maximum Allowable Cost) lists and protocols

Support client retention, renewals, upsells and client satisfaction

Provide review and evaluation of client and prospect drug utilization review, provide financial and clinical insights to support internal and external client needs

Provide review and advice on Pharmacy Provider Contracting when required

Review, edit, maintain, or create and support standard and client-specific Drug Utilization and financial impact reporting protocols

Review, edit, maintain, or create and support the additions of new specialty, brand, and generic product introductions

Review, edit, maintain, or create and support standard and client-specific Rebate contracts and performance guarantees associated with such contracts

Review, edit, maintain, or create and support the development of an organizational standard for MSP (manufacturer savings programs), PAP (patient assistance programs), CAP (copay assistance programs) assisting clients in attaining the maximum plan and member benefits of such programs

Review, edit, maintain, and support the standard operating procedures for external advocacy companies that provide MSP (manufacturer savings programs), PAP (patient assistance programs), CAP (copay assistance programs), and assist clients in attaining maximum plan and member benefits of such programs

Support the standard operating procedures for clients that create and service pharmaceutical manufacturers regarding MSP (manufacturer savings programs), PAP (patient assistance programs), and CAP (copay assistance programs) where AMPS/Drexi is the back-end claims processor for such claims

Facilitate the appropriate claim migration and utilization of international drug sourcing for clients that have adopted this strategy

Support clinical and financial review of multiple accounts; develop a positive working relationship with all client touchpoints when and where necessary

Focus on ensuring we maintain superior customer service levels, operational excellence and strategic insight

Support new business implementations

Maintain account activity within the CRM system

Closely coordinate with Marketing, Product, and Sales areas on applicable initiatives as directed by leadership

Other training and project initiatives as directed and assigned by leadership

Qualification

PBM industry knowledgePharmacy LicenseData managementHealthcare experienceAnalytical skillsCustomer serviceCommunication skillsProblem-solving skillsOrganizational skillsTeamwork

Required

Excellent verbal and written communication skills

Strong understanding of the PBM industry required

Excellent customer service skills

Strong analytical and problem-solving skills

Confident decision-making abilities

Detail-oriented, flexible, and strong organizational skills

Ability to work independently and within a team environment

Ability to travel on an as-needed basis

Bachelor's Degree from an accredited US School of Pharmacy

Current Pharmacy License in good standing with the state that has issued that license

Minimum of 5 - 7+ years pharmacy experience within the PBM or Managed Care industry